| 引用本文：王雪梅, 唐玉清, 杜亚玲, 郭新红, 张新平.基于间断时间序列模型的辅助用药监管政策干预效果研究[J].中国卫生政策研究,2021,14(3):57-63 |
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| 基于间断时间序列模型的辅助用药监管政策干预效果研究 |
| 投稿时间：2021-01-03 修订日期：2021-03-03 PDF全文浏览 HTML全文浏览 |
| 王雪梅1, 唐玉清1, 杜亚玲1, 郭新红2, 张新平1 |
1. 华中科技大学同济医学院医药卫生管理学院 湖北武汉 430030;
2. 石河子大学医学院第一附属医院药剂科 新疆石河子 832008 |
| 摘要:辅助用药的不合理使用导致了医疗资源浪费、药物不良反应风险增加以及患者经济负担加重等诸多问题。为了促进合理用药、减轻患者用药经济负担，本研究聚焦于湖北省基层医疗卫生机构辅助用药的使用情况，以2018年8月为政策干预时点，回顾性收集干预前(2017年1月—2018年7月)和干预后(2018年8月—2019年10月)全省基层医疗卫生机构辅助用药的每月采购金额，基于间断时间序列模型开展辅助用药监管政策的干预效果评估研究，识别出未来需要重点监管的辅助用药种类、属性或剂型。结果显示监管政策能够在一定程度上减少辅助用药采购金额，尤其对神经节苷脂、脑蛋白水解物等神经营养类基本药物的干预效果显著，但对活血类中药注射剂等补充药物还需进一步加强监管，可以通过制定辅助用药临床应用指导原则、推进分级管理、持续开展动态监测、加强公开透明度与相关培训等措施进一步规范其合理使用。 |
| 关键词:辅助用药 监管政策 干预 采购金额 间断时间序列 |
| 基金项目:国家自然科学基金资助（72074085） |
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| Intervention effects of supervision policy on adjuvant medicine based on interrupted time series analysis |
| WANG Xue-mei1, TANG Yu-qing1, Du Ya-ling1, GUO Xin-hong2, ZHANG Xin-ping1 |
1. School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan Hubei 430030, China;
2. Department of Pharmacy, the First Affiliated Hospital of School of Medicine, Shihezi University, Shihezi Xinjiang 832008, China |
| Abstract:The non-reasonable utilization of adjuvant medicines led to a waste of medical resources, an increase of adverse medicine reaction risks, heavy economic burden on patients and many other negative consequences. In order to promote rational utilization of medicines and lessen economic burden of medication faced by patients, this study focused on the use of adjuvant medicines in primary healthcare institutions located in Hubei province. Monthly procurement cost data were retrospectively collected, and emphasis was put on the periods of pre-intervention (in the period of January 2017-July 2018) and post-intervention (during the period from August 2018 to October 2019), respectively, with August 2018 as the intervention time point. Interrupted time series analysis was carried out to evaluate the intervention effects of the supervision policy on these medicines, so as to identify the types, attributes or dosage form of adjuvant medicines that require special supervision in the future. The results showed that supervision policy can restrict the procurement cost of adjuvant medicines to some extent, especially for essential medicines such as neurotrophic adjuvant medicines, including gangliosides and cerebroprotein hydrolysates or brain protein hydrolysates. However, regarding the active blood herbal injection in China, it is necessary to further develop clinical application guidelines, promote graded management, continuously carry out dynamic monitoring and strengthen transparency as well as relevant training to promote the rational utilization of adjuvant medicines nationwide. |
| Key words:Adjuvant medicine Supervision policy Intervention Procurement cost Interrupted time series analysis |
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